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      Association between ABO blood groups and postoperative pain in children after adenotonsillectomy: a prospective cohort study

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          Abstract

          Background

          It has been known that ABO blood groups are linked to the phenotypes of certain diseases; however, and the relationship between ABO blood groups and postoperative pain have not been extensively studied, especially in children. This study was to investigate whether there would be an association between the four major ABO blood groups and postoperative pain, as indicated by the differences in pain scores and rescue fentanyl requirements among blood groups in children after adenotonsillectomy.

          Methods

          A total of 124 children, aged 3–7 years, ASA I or II, and undergoing elective adenotonsillectomy were enrolled in the study. Postoperative pain was evaluated using the Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) and the rescue fentanyl requirement in post anesthesia care unit (PACU) was analyzed. Pediatric Anesthesia Emergence Delirium (PAED) score and the duration of PACU were recorded. The postoperative nausea and vomiting (PONV) within 24 h were documented.

          Results

          Among four blood type groups, no significant differences were observed regarding surgery time, and the gaps of fentanyl given at the anesthesia induction and the first rescue fentanyl injection in PACU. However, patients from AB and B blood groups had significantly higher pain score at initial CHEOPS assessment and consequently, higher consumption of rescue fentanyl during PACU stay. A significantly higher percentage of patients had received > 1 μg/kg rescue fentanyl. Higher PAED scores were also observed in AB and B blood groups.

          Conclusion

          Paediatric patients with AB and B blood type had higher postoperative CHEOPS pain score and required significantly more fentanyl for pain control than those with A and O blood type after T&A. The initial scores of PAED in patients with AB and B blood type were also higher than that in patients with A and O blood type.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12871-022-01953-6.

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          Most cited references17

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          Genetic contributions to pain: a review of findings in humans.

          Pain represents the major motivating factor for which individuals seek healthcare, and pain responses are characterized by substantial inter-individual differences. Increasing evidence suggests that genetic factors contribute significantly to individual differences in responses to both clinical and experimental pain. The purpose of this review article was to summarize the current literature regarding genetic contributions to pain, highlighting findings relevant to oral pain where available. A brief discussion of methodologic considerations is followed by a review of findings regarding genetic influences on clinical pain. Next, the literature examining genetic contributions to experimental pain responses is presented, emphasizing genetic associations that have been replicated in multiple cohorts. It is hoped that an enhanced understanding of genetic contributions to pain responses will ultimately improve diagnosis and treatment of clinical pain conditions.
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            Trends in the indications for pediatric tonsillectomy or adenotonsillectomy.

            To report trends in the indications for pediatric tonsillectomy or adenotonsillectomy. To identify current indications, (1) a retrospective chart review analyzed all indications for procedures performed by a pediatric otolaryngologist on patients aged 0-3, 4-10, or 11-18 years, and (2) a cross-sectional survey to members of the American Society of Pediatric Otolaryngology asked for approximate percentages of children in the same age groups receiving procedures for obstruction, infection, or another indication. To assess changing indications over time, (3) a literature review was performed. (1) Chart review: 302 patients aged 5 months to 18 years (average: 6.34; median: 6) were analyzed. For the 0-3-year age group, obstruction was an indication in 100.0% of cases, and infection in 2.6%. For the 4-10-year age group: 91.9% and 13.4%, respectively. For the 11-18-year age group: 84.6% and 33.3%. (2) SURVEY: 120 surveys were returned (40% response rate), and 63 surveys were appropriate for analysis (21% completion rate). For the 0-3-year age group, obstruction was the primary indication in 91.8% of procedures and infection in 7.5%. For the 4-10-year age group: 73.2% and 25.3%, respectively. For the 11-18-year age group: 43.0% and 54.2%. (3) LITERATURE REVIEW: 11 articles consistently illustrated a rise in obstruction and a decline in infection as an indication since 1978. Obstruction has become a more prominent indication than infection for pediatric tonsillectomy or adenotonsillectomy in children, especially younger children. Infection becomes a more prominent indication as age increases. Data may not be absolutely reflective of all pediatric otolaryngologists or other otolaryngologists that treat children. Comparing studies is difficult owing to the variety of surgical procedures focused upon and terms used to define indications. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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              Toward validation of pain measurement tools for children: a pilot study.

              We undertook to explore the validity of pain measurement tools for use in children in the postoperative period. The general approach was to determine the extent to which a measurement tool conformed with the clinical expectations about pain in the postoperative period; namely, that pain is low prior to surgery, increases following surgery, decreases with pain medication and decreases over time following surgery. In children aged 6 months to 3 years, we evaluated the CHEOPS and Observer pain scales. In children 3-6 years of age, we used the CHEOPS, Observer and Faces scale. In children 6-12 years of age, we studied the CHEOPS, Faces and visual analogue scales. In all instances, each of the scales conformed with the clinical expectations about pain following surgery. In addition, these scales were correlated with each other. Within the limitations of the measurement techniques used, these data provide support for the validity of the measurement tools evaluated.
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                Author and article information

                Contributors
                junzheng.wu@cchmc.org
                Journal
                BMC Anesthesiol
                BMC Anesthesiol
                BMC Anesthesiology
                BioMed Central (London )
                1471-2253
                28 December 2022
                28 December 2022
                2022
                : 22
                : 407
                Affiliations
                [1 ]Department of Anesthesiology, Quanzhou Women’s and Children’s Hospital, Fujian Province, Quanzhou, China
                [2 ]Department of Otolaryngology, Quanzhou Women’s and Children’s Hospital, Fujian Province, Quanzhou, China
                [3 ]GRID grid.239573.9, ISNI 0000 0000 9025 8099, Department of Anesthesiology, , Cincinnati Children’s Hospital Medical Center, ; Cincinnati, OH USA
                Article
                1953
                10.1186/s12871-022-01953-6
                9795585
                36577969
                10d2269b-865d-45b2-8360-90c01a905ded
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 30 August 2022
                : 21 December 2022
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Anesthesiology & Pain management
                abo blood groups,postoperative pain,paediatrics,adenotonsillectomy

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